High-resolution CT scoring system-based grading scale predicts the clinical outcomes in patients with idiopathic pulmonary fibrosis

Respiratory Research

Hiroshi Mukae⁴  Toshinori Kawanami⁴  Hiroyuki Nakao²  Toru Tsuda¹  Tomotoshi Imanaga³  Kei Yamasaki⁴  Takaaki Ogoshi⁴  Keisuke Naito⁴  Kazuhiro Yatera⁴  Hiroshi Ishimoto⁴  Keishi Oda⁴ 

[1] Department of Medicine, Kirigaoka Tsuda Hospital, 3-9-20 Kirigaoka, Kokuraminamiku, Kitakyushu City, Fukuoka 802-0052, Japan;Department of Epidemiology, National Institute of Public Health, Wako, Saitama, Japan, 2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan;Department of Respiratory Medicine, Steel Memorial Yawata Hospital, 1-1-1, Harunomachi, Yahatahigashiku, Kitakyushu City, Fukuoka 805-8508, Japan;Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan

关键词: Idiopathic pulmonary fibrosis;    Monitoring methods;    Spirometry;    UIP pattern;    HRCT fibrosis score;   

Others  :  790735
DOI  :  10.1186/1465-9921-15-10

 received in 2013-10-28, accepted in 2014-01-27,  发布年份 2014

【 摘 要 】

Background

The 2011 idiopathic pulmonary fibrosis (IPF) guidelines are based on the diagnosis of IPF using only high-resolution computed tomography (HRCT). However, few studies have thus far reviewed the usefulness of the HRCT scoring system based on the grading scale provided in the guidelines. We retrospectively studied 98 patients with respect to assess the prognostic value of changes in HRCT findings using a new HRCT scoring system based on the grading scale published in the guidelines.

Methods

Consecutive patients with IPF who were diagnosed using HRCT alone between January 2008 and January 2012 were evaluated. HRCT examinations and pulmonary function tests were performed at six-month intervals for the first year after diagnosis. The HRCT findings were evaluated using the new HRCT scoring system (HRCT fibrosis score) over time. The findings and survival rates were analyzed using a Kaplan-Meier analysis.

Results

The HRCT fibrosis scores at six and 12 months after diagnosis were significantly increased compared to those observed at the initial diagnosis (p < 0.001). The patients with an elevated HRCT fibrosis score at six months based on a receiver operating characteristic (ROC) curves analysis had a poor prognosis (log-rank, hazard ratio [HR] 2.435, 95% CI 1.196-4.962; p = 0.0142). Furthermore, among the patients without marked changes in %FVC, those with an elevated score above the cut-off value had a poor prognosis (HR 2.192, 95% CI 1.003-4.791; p = 0.0491).

Conclusions

Our data demonstrate that the HRCT scoring system based on the grading scale is useful for predicting the clinical outcomes of IPF and identifying patients with an adverse prognosis when used in combination with spirometry.

【 授权许可】

   
2014 Oda et al.; licensee BioMed Central Ltd.

【 图 表 】

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